Adventures in Obamacare

My cold wasn’t getting any better after two weeks so I went to the doctor. The receptionist asked for my insurance card. This is a “silver” Obamacare policy that costs $8,460 per year. I noticed that the co-pays are now higher than what the corresponding services typically cost not that long ago (and therefore higher than the market price today in a lot of rich countries). A generic prescription is $20; branded drugs will be $60 or $90 if they are covered at all. An office visit is $30 or $50. A few stitches at the “ER”? $700 co-pay.

My appointment was right after the lunch break so I was seen almost as fast as a dog would be seen at a vet. A sinus infection was diagnosed. “I used to prescribe Erythromycin for this,” the doctor said, “and it was a couple of pennies a pill. Now it is $200 for a course so I’m going to give you a Z-pack.” How was it possible for a generic to cost $200? “I think the generic manufacturer was acquired.” (Medscape says that “For example, erythromycin in 500-mg tablets had three increases of more than 100%. Its price increased from 24 cents per tablet in 2010 to $8.96 per tablet in 2015.” while Wikipedia gives the wholesale price at 3-6 cents in countries not subject to U.S. government regulation.)

[Separately, I posted this story on Facebook and a passionate Hillary Clinton supporter living in the Bay Area responded with

I know it’s crazy. Just this week I slightly scratched my back bumper on my car, but because my car insurance has a $500 deductible, I had to pay the whole thing myself. And to think I pay $1700/year in car insurance for me and my wife… clearly I’m losing money on this deal!

(or, you know, that’s how insurance works.)

Is the analogy apt? I haven’t had any health problems in the last two years nor changed my plan or vendor yet the cost of insurance has doubled while the emergency room deductible went from $100 to $700. I haven’t seen car, home, or aircraft insurance rates rise. In fact, my Obamacare policy now costs about the same as what a private owner would pay for insurance on a $2 million turbine-powered aircraft in which as many as 11 people might be killed if the single non-professional pilot should make a mistake. Thus it now costs as much to insure someone against the hazard of falling into the hands of the world’s least efficient medical system as it does to insure 11 people against the hazard of flying through the air at 300+ mph.]

What does marriage mean to people who support gay marriage?

A middle-aged married father of two, in between his ecstatic praise of Barack Obama and enthusiastic expressions of support of Hillary Clinton, often mentions his passion for gay marriage. Another subject of which this Bay Area dweller is fond is the pernicious influence of Christianity and Judaism on American society. The other day he said that he couldn’t stand conservative Christians for suggesting that Americans were descending into anarchy due to an abandonment of Christian values.

I asked “Without Christian values or similar cultural ones, wouldn’t a man be free to abandon his middle-aged wife and young children in favor of a childless 25-year-old woman?” He replied “If he needs to do that I wouldn’t judge him.” What about the woman who leaves her husband and kids to travel the world in an Eat, Pray, Love-style journey of self-discovery? It turned out that was okay as well.

The conversation reminded me of one that I had recently with a college student (and, of course, therefore at least a moderately outspoken advocate for LGBTQIA rights). His non-working mom, attractive at nearly 50, had sued his high-income father and used the resulting cash to enjoy a sex-and-travel relationship with a man just over 30. The student acknowledged that the divorce had a devastating effect on him and his sibling, ruining their teenage years. However, he said that he thought that his mother was right to break up their home because “people shouldn’t stay married if there is no passion.” I asked “So if a guy is married to a woman who is exhausted from running after kids and thus tends to collapse at night before the question of passion becomes relevant, he should feel free to seek passion with a 22-year-old off craigslist?” The answer turned out to be basically “yes” because in deciding whether or not to stay married there were no important considerations other than the passion currently experienced by one of the married adults.

I’m wondering if the whole gay marriage debate among heterosexuals was the result of the two sides misunderstanding each other’s concept of “marriage.” Marriage under the law of a typical U.S. state is a temporary financial arrangement that can be terminated by either party for any reason (“no fault”; see Real World Divorce). But citizens often invest the term with additional meaning. Perhaps the hetero anti-gay-marriage folks dragged in concepts from religion and ideas that marriage might involve a personal sacrifice? While the hetero pro-gay-marriage folks added in stuff about passion and personal satisfaction? So they ended up talking past each other and, though using the same word, were talking about two different things.

Related:

Keeping black women on the NASA plantation

From a Facebook friend regarding Hidden Figures (movie) who works for the government and is still mourning Hillary Clinton’s loss:

It really was an excellent film (and a very insightful interview about the story), and captured much of what I experienced [as a white male?]. It left me very conflicted, however. First, I was awed (and loved) that it so honored the long unsung minority (and female) contributions and that my former employer (NASA) was such an unusual agent of change and inclusion. I very much appreciated the pointed lessons at a time when our country seems to be retreating from these ideals. But at the same time I felt a sense of shame and disgust that so many of the same issues persist to this day, and that too many people who need to receive those messages are either unlikely to even see the film, and even so, are unlikely to recognize the persistent biases that are ongoing even today.

I worked on the NASA plantation as a Fortran programmer on the Pioneer Venus project for $13,000 per year back in 1978 (that’s $47,854 in today’s mini-dollars). My co-workers included women, Indians, Chinese, white males, etc. Other than receiving a paycheck, all of us were “unsung” for our contributions of software for the PDP 11/70 and the IBM 360/95.

I’m not sure why the (white male) author of the above posting thinks he is doing women a favor by encouraging them to become “nameless faceless scientists” (see Bill Burr at about 0:50) at one-fifth the salary of a dermatologist (see “Women in Science” for a comparison of the career trajectories). Maybe this is actually how white men will keep women and, specifically, women of color, down? Encourage them to become quiet nerds in a cubicle farm instead of going into medicine, politics, etc.?

Why does Jeff Sessions want to quit the Senate and become Attorney General?

During my annual visit to the gym today I saw Jeff Sessions being grilled about his suitability for the job of Attorney General. I had never been previously aware of the guy and hadn’t seen him on TV before today so I don’t have an opinion as to his fitness for the job. My stupid political question for today is why would he want to switch from senator (making the law) to Attorney General (enforcing whatever laws the Senate happens to make).

Wikipedia says that he has been a senator for 20 years. Thus boredom is a potential explanation. But what else? What is so great about being Attorney General that a senator would want to quit?

[Also at the gym, I overheard a woman talking to her personal trainer about how she had recently ended a 35-year friendship with another woman. Why? It seems that the long-time friend had refused to support Hillary Clinton. “She just doesn’t see that Trump’s attitude will trickle down to everyone,” said the exerciser. I also met a guy with a remarkably lifelike portrait of a long-haired woman on his calf. It was at least as detailed as a Wall Street Journal hedcut. He’d gotten it before getting married down in Texas, 15 years earlier: “fortunately I still like my wife.” He moved up here just two months ago. Let’s hope that the difference in profitability for a plaintiff under Massachusetts family law compared to Texas family law doesn’t motivate his wife to make a trip down to the courthouse! (Papers referenced from the Causes of Divorce chapter show how changes in the prevailing law can make people more or less likely to sue for divorce.)]

New group for Hillary supporters: White Man’s Burden

It’s a new year so maybe it is a time for a new group.

Following Hillary Clinton’s defeat, one of my white male programmer friends (mid-50s now and therefore in the sunset of his career in this young person’s field) posted the following on Facebook:

I would really hate to be gay, or a woman, or a minority, or an American right now.

Of course I couldn’t resist suggesting that he visit Abigail Johnson “to comfort her on the coming tough times?” (Johnson is the richest person in Boston.) I pointed out that “if you want to feel sorry for someone who identifies as ‘gay’, Peter Thiel could perhaps use a hug.” I ended with “This black American also merits your sympathy: http://www.forbes.com/profile/robert-smith/

A few days later, Facebook friends signaled their intention to join the “Million Women March” on Washington, D.C.: “ALL women, femme, trans, gender non-conforming and feminist others are invited to march on Washington DC the day following the inauguration of the President elect. ”

What did the Facebookers who plan to participate in the Million Women March have in common? None of them were “women.” As with the above exchange, the passionate Hillary supporters were white males.

In their 50-60 years on the planet, none of these folks had ever written anything about Jews except to criticize the Jews of Israel for being the world’s most horrible and pernicious people. Ever since Trump’s election, however, they’d devoted themselves with passion to protecting American Jewry from Manhattan/LA/South Florida-based Jew-haters (i.e., Trump and Steve Bannon):

Steve Bannon is a known antisemite, as well as an abuser. Wake the fuck up, this is NOT okay!!

URGENT. RED ALARM. This is an EMERGENCY. (I do not use those words lightly.) Donald Trump just appointed an anti-Semitic white supremacist bigot as his chief advisor and strategist.

Steve Bannon, our nation’s foremost antisemite, is now WH senior council.

If you believe that an antisemite, woman-abuser, white supremacist dirtbag like Steve Bannon has no place in the White House, then I suggest calling these representatives and telling them directly.

White supremacist and antisemite Steve Bannon will serve as chief strategist and senior counselor in the Trump White House. This is only the beginning.

[Note that the “abuser” stuff comes out of a lawsuit for custody and child support profits filed against Bannon by a former wife. The allegation reported by newspapers was based on an affidavit from the cash-seeking plaintiff, a not atypical situation in the American family courts.]

A couple of weeks later these same folks had rallied around the idea of creating sanctuaries for undocumented immigrants (it turns out that almost every place in the U.S. is a suitable sanctuary except for their own houses). They had also pledged to register as Muslim in what they said was “Donald Trump’s proposed database of Muslim-Americans.”

I’m thinking that I could harness the power of these good-hearted Facebook friends who want to use their elite educations, $150,000/year incomes, and spare time to help the female, the gay, the non-white, and even the persecuted Jews. My new group will be called “White Man’s Burden.”

Structure: No dues or actions required beyond some virtuous-sounding postings on Facebook.

Thoughts?

College-educated Americans will have fewer children in the Trumpenfuhrer era?

“I’m Terrified of Raising a Boy in Trump’s America” (Elle) is kind of interesting. From the pregnant author:

Perhaps caught up in the momentum of the potentially ceiling-shattering election, I imagined the pea-size embryo was a girl and enjoyed a certain camaraderie as I cast my ballot, pleased about the stories I’d later tire her with about how she and I voted together for the first woman president. … I’d been sure I’d be raising a small woman during a new age of feminism, one where we didn’t even need to call it feminism anymore, one where it was normal for a woman to be the leader of the free world. But that was no longer the case.

It’s not the stereotypical boy things that worry me. … What terrifies me is the idea of raising a boy with good values when a man who represents the male stereotypes we’ve been fighting for generations is in the White House. A man who bullies both men and women in person and on Twitter. This man could dominate our news cycle for the next eight years. I can’t hide his bad behavior from our son.

How can I explain to a little boy that the year he was born, the President of the United States was an admitted sexual predator… How do I explain that grabbing a woman by her genitals is not an acceptable salutation when the man in charge of the country normalized it?

We can talk to him about the man who was in office when he was conceived, a self-declared feminist who made the world a better place for men and women of all colors and stripes.

I’ll start on January 21. I’ll be nearly five months pregnant when I travel to Washington, D.C., to march with thousands of other women who want to show our new president that there will be consequences for bad behavior.

According to Pew Research, “College graduates backed Clinton by a 9-point margin (52%-43%)”. If the author of this piece is typical of the thinking of Hillary supporters, could it be that there will be a further decline in fertility among America’s college-educated citizens?

[Separately, I kind of like the way she spins her personal loss (of the beloved President Obama) and disappointment (about not being ruled by Hillary Clinton) into altruistic concern regarding an unborn child (whose life can be terminated, legally, in Massachusetts for another two months, potentially for cash compensation). It reminds me of that meeting here in the Boston suburbs where adults were supposed to learn how to talk to their children about the election result but instead kept turning the focus onto themselves. Her son won’t even be 8 years old before King Donald I is history. Which of Donald Trump’s points of view did she think might interest a 6- or 7-year-old child?]

Russian Empress Stories to Comfort Hillary Supporters

For my readers who are disappointed that Hillary Clinton didn’t win the recent election, let me devote a few days of weblog to stories about the female rulers of Russia, based on a recent reading of Catherine the Great (Massie).

The first Empress of Russia was Catherine I. She got the job the same way that Hillary had hoped to… by being married to Peter the Great. Unfortunately she died after just two years on the job, aged 43.

The next Empress was Anna:

When the Imperial Council of Russia offered her the throne, the offer was hedged with many conditions: she was not to marry or appoint her successor, and the council was to retain approval over war and peace, levying taxes, spending money, granting estates, and the appointment of all officers over the rank of colonel. Anne accepted these conditions and was crowned in Moscow in the spring of 1730. Then, with the support of the Guards regiments, she tore up the documents she had signed and reestablished the autocracy.

She was succeeded by an infant, Ivan VI, and a regent. This reign was brief:

Elizabeth decided to act. At midnight, she set off for the barracks of the Preobrazhensky Guards. There, she said, “You know whose daughter I am. Follow me!” “We are ready,” shouted the soldiers. “We will kill them all.” “No,” said Elizabeth, “no Russian blood is to be spilled.” Followed by three hundred men, she made her way through a bitterly cold night to the Winter Palace. Walking past the unprotesting palace guards, she led the way to Anna Leopoldovna’s bedroom, where she touched the sleeping regent on the shoulder and said, “Little sister, it is time to rise.” Realizing that all was lost, Anna Leopoldovna begged for mercy for herself and her son. Elizabeth assured her that no harm would come to any member of the Brunswick family. To the nation she announced that she had ascended her father’s throne and that the usurpers had been apprehended and would be charged with having deprived her of her hereditary rights. On November 25, 1741, at three o’clock in the afternoon, Elizabeth reentered the Winter Palace. At thirty-two, the daughter of Peter the Great was the empress of Russia.

Elizabeth ruled for about 20 years and required some harsh measures, including imprisoning her young relative, Ivan VI:

But Elizabeth’s most pressing problem could not be resolved with largesse. A living tsar, Ivan VI, remained in St. Petersburg. He had inherited the throne at the age of two months, he was dethroned at fifteen months, he did not know he was emperor, but he had been anointed, his likeness had been scattered through the country on coins, and prayers had been offered for him in all the churches of Russia. From the beginning, Ivan haunted Elizabeth. She had originally intended to send him abroad with his parents, and, for this reason, she packed the entire Brunswick family off to Riga as a first stage of their journey west. Once they arrived in Riga, however, she had a second thought: perhaps it would be safer to keep her small, dangerous prisoner securely under guard in her own country. The child was removed from his parents and classified as a secret state prisoner, a status he retained for the remaining twenty-two years of his life. He was moved from one prison to another; even then, Elizabeth could not know when an attempt to liberate him and restore him to the throne might be made. Almost immediately, a solution suggested itself: if Ivan was to live and still be rendered permanently harmless, a new heir to the throne must be found, a successor to Elizabeth who would anchor the future of her dynasty and be recognized by the Russian nation and the world. Such an heir, Elizabeth knew by then, would never come from her own body. She had no acknowledged husband; it was late now, and no one suitable would ever be found. Furthermore, in spite of her many years as a carefree voluptuary, she had never known pregnancy. The heir she must have, therefore, must be the child of another woman. And there was such a child: the son of her beloved sister, Anne; the grandson of her revered father, Peter the Great. The heir whom she would bring to Russia, nurture, and proclaim was a fourteen-year-old boy living in Holstein.

The boy would turn out to be Catherine the Great’s husband, deposed and dispatched rather quickly by Catherine. Once on the throne, Catherine would continue to take precautions against Ivan VI:

In March, Peter visited the grim Schlüsselburg Fortress, where the former emperor, Ivan VI, deposed by Empress Elizabeth, had been confined for eighteen years. Peter, certain that his own place on the throne was secure, thought of giving Ivan an easier life, perhaps even of releasing him and appointing him to a military post. The condition of the man he found made these plans impossible. Ivan, now twenty-two, was tall and thin, with hair to his waist. He was illiterate, stammered out disconnected sentences, and was uncertain about his own identity. His clothes were torn and dirty, his bed was a narrow pallet, the air in his prison room was heavy, and the only light came from small, barred windows high up in the wall. When Peter offered to help, Ivan asked whether he could have more fresh air. Peter gave him a silk dressing gown, which the former emperor hid under his pillow. Before leaving the fortress, Peter ordered a house to be built in the courtyard where the prisoner might have more air and more room to walk.

Ivan had been eighteen months old in 1740 when Elizabeth removed him from the throne. When he was four, he was separated from his parents. He had received no formal education but in childhood had been taught the Russian alphabet by a priest. Now twenty-four, he had spent eighteen years in solitary confinement in an isolated cell in the Schlüsselburg Fortress, fifty miles up the Neva River from St. Petersburg. Here, designated Prisoner No. 1, he was allowed to see no one except his immediate jailers. There were reports that he was aware of his identity; that once, goaded to anger by his guards, he had shouted, “Take care! I am a prince of this empire. I am your sovereign.” A report of this outburst brought a harsh response from Alexander Shuvalov, head of Elizabeth’s Secret Chancellery. “If the prisoner is insubordinate or makes improper statements,” Shuvalov instructed, “you shall put him in irons until he obeys, and if he still resists, he must be beaten with a stick or a whip.” Eventually, the guards reported, “The prisoner is somewhat quieter than before. He no longer tells lies about his identity.” Elizabeth continued to worry and, on the empress’s command, Shuvalov issued a further instruction: if any attempt to free Prisoner No. 1 seemed likely to succeed, Ivan’s jailers were to kill him.

To protect herself, [Catherine] ordered a continuation of the severe conditions in which he had previously been held. Nikita Panin was assigned to oversee Ivan’s imprisonment.

Catherine’s lieutenants ultimately found an excuse to kill Ivan VI and Catherine reigned for decades afterwards, though not as absolutely as one might think:

She rejected torture, traditionally used in extracting confessions, obtaining evidence, and determining guilt in Russia. “The use of torture is contrary to sound judgment and common sense,” she declared. “Humanity itself cries out against it, and demands it to be utterly abolished.” She gave the example of Great Britain, which had prohibited torture “without any sensible inconveniences.”

Years later, Potemkin’s aide, V. S. Popov, elaborated on this by telling the young Emperor Alexander I of a conversation he had once had with the empress: The subject was the unlimited power with which the great Catherine ruled her empire.… I spoke of the surprise I felt at the blind obedience with which her will was fulfilled everywhere, of the eagerness and zeal with which all tried to please her. “It is not as easy as you think,” she replied. “In the first place, my orders would not be carried out unless they were the kind of orders which could be carried out. You know with what prudence and circumspection I act in the promulgation of my laws. I examine the circumstances, I take advice, I consult the enlightened part of the people, and in this way I find out what sort of effect my laws will have. And when I am already convinced in advance of good approval, then I issue my orders, and have the pleasure of observing what you call blind obedience. That is the foundation of unlimited power. But, believe me, they will not obey blindly when orders are not adapted to the opinion of the people.”

More: Read Catherine the Great.

Move to a state where people aren’t upset about the election result?

In response to “How was your weekend?” my neighbors here in Massachusetts are responding with “sad”. Why sad? They’re in mourning for Hillary Clinton’s loss, which they feel personally. Massachusetts residents were already down at #30 (out of 50) in this state-by-state happiness ranking. As the smartest people on the planet we tend to take it personally when we’re not consulted by those in power down in New York and D.C. I don’t see King Donald the First calling up Harvard professors to ask for advice. Thus it is going to be a dark and moody 4-8 years.

Why not move to a state that ranked higher to begin with and one where we don’t think Hillary’s loss will sadden people, either because (a) the majority of voters in that state supported Trump, or (b) voters in that state don’t expect to have substantial influence in a country of 325 million.

Number 1 on the list is Hawaii, which voted for Hillary but is so far from D.C. it is tough to imagine folks there feeling responsible for what the Trumpenfuhrer does.

Number 2 is Alaska, which voted for Trump and where global warming may not be feared. Bonus: no income tax. Double bonus: permanent fund dividend (more of which you’ll get to keep under Trump’s proposed lower federal income tax rates).

Number 3 is Montana, another Trump state. Colorado is #4 and the vote was narrowly divided. Perhaps stay away from Boulder and people will be in a good mood?

Wyoming has no state income tax, supported Trump, and was #5 in happiness prior to the election. Texas and Florida have no state income tax, rank #11 and #12, and voted for Trump.

What do folks think? If the post-election malaise will be prolonged for Hillary Clinton supporters, why not move away from it to a state that ranked higher in happiness to begin with? Why choose to live around the grumpy?

[Be sure to check Real World Divorce before moving! The alimony and child support plaintiff who gets $10 million in Massachusetts would be entitled to $400,000 in Texas. The custody plaintiff entitled to sole custody (“winner parent” status) in New York would be forced into shared 50/50 parenting in Alaska.]

My Dolphin Joke was NOT FUNNY?

A few days ago I posted a three-second video on Facebook (equivalent YouTube version) with the following caption: We met this dolphin in Sarasota. He said that he voted for Trump because he is enthusiastic about global warming and sea level rise. Why, we asked? “I want to move into a third floor condo in Miami,” he replied.

My Facebook friends, nearly all of whom supported Hillary Clinton, did not think this was funny! Is that because (a) it is in fact not funny, (b) they have a poor sense of humor, or (c) they’re still using up all of their emotions mourning the loss of President Hillary?

[Note that, as an engineer, I think that any solution to problems caused by atmospheric CO2 will be engineering and infrastructure solutions. The U.S. is a shrinking percentage of global CO2 output. We tend to be led by politicians with no technical or scientific background (see Why would anyone expect the U.S. to be a leader in dealing with CO2 emissions, climate change, etc.?).  We are no longer great at engineering and we’re terrible at building infrastructure (see U.S. versus German infrastructure spending and results and High-speed Rail in California versus China). If the Earth does need to be saved from humans, I think that it will be Chinese and Germans who do the saving and therefore the American public’s choice of a president is not relevant.]

Best asphalt shingles?

Some choices are even tougher than Hillary Clinton v. Donald Trump…

We’re using a conventional wood-frame house as a combination of office and home. It was built in the late 1960s with perhaps 10 inches of fiberglass between the rafters. There are cathedral ceilings everywhere, hence no possibility of insulating an attic (no attic! Also no basement; architects back then were smart enough to foresee that America would become less cluttered and there would be no need to store anything). The basic shape of the house is the same as a double-wide trailer home. (But of course Zillow estimates the value at about $1 million due to the proximity to Boston and the general impracticality of building anything new in Massachusetts.)

A local architect suggested putting nail-base foam panels on top of the existing roof deck. This gives 3.5 inches of foam and and then another 0.5″ of OSB to which shingles can be nailed. Apparently this is a fairly common retrofit insulation technique for old-yet-modern-style houses like this one. There would be some foam injected into any gaps between the panels.

We then have a choice of whether to do ice-and-water shield over the entire roof or just the lower 6′. The advantage of not doing the whole thing is that maybe water vapor would have a better chance to escape?

On top of the ice-and-water shield we then have to pick shingles. This is where I am hoping to get answers from readers! Consumer Reports tested shingles in 2009 and found that high-end Owens Corning Berkshire Collection and CertainTeed Grand Manor were the best (strongest). Owens Corning Oakridge and CertainTeed Landmark were pretty good at about one third the price. The roof is only about 3750 square feet including budgeted waste, so I don’t think that the shingle price difference will be that large in the overall context of the project.

What do folks who’ve been through this recently have to say? How did you choose a shingle and what did you choose?

One more idea: Should we try to hold out for another year and get the Tesla solar energy tiles? It looks like a good product, but I wonder if it will be shipped within my lifetime. Also you probably wouldn’t want to do the north side of your house with these, right? So then you are supposed to find matching non-solar shingles for the north side?

[Note that this continues the theme of why you want to rent rather than buy; the brain of the homeowner is entirely filled up with boring stuff.]